Michlovitzs Modalities for Therapeutic

Intervention 6th Edition Bellew Test

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Chapter 7: Spinal Traction

Multiple Choice

1. Mechanical traction is unlikely to be effective in achieving which of the following?

A. Separation of vertebral bodies
B. Distraction of vertebral facet joints
C. Stretching of soft tissues of the spine
D. Permanent reduction of herniated nucleus pulposus

ANS: D

2. What is the evidence on the effect of cervical traction on intervertebral foramina dimensions?
A. Decrease during traction application
B. Correction of intervertebral foraminal impingement
C. Increase during traction application
D. No effect on foramina dimensions

ANS: C

3. What is the evidence of the effect of lumbar traction on intradiscal pressures?

A. Intradiscal pressures increase during traction then gradually decrease after traction.
B. Intradiscal pressures decrease during traction then rapidly return to normal after traction.
C. There is no effect on intradiscal pressure during or after traction.
D. The effect on intradiscal pressure during traction is unpredictable.

ANS: B

4. How much traction force is required to overcome friction of the lower body when doing
lumbar traction?
A. One-half to three-quarters of body weight
B. Approximately 20 pounds
C. Up to approximately one-half of body weight
D. Greater than 150 pounds

ANS: C

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5. How can the friction provided by the patient’s superincumbent body weight be significantly
reduced during lumbar traction?
A. Unlock the table so segments can be separated.
B. Place the legs on a stool in the 90/90 position.
C. Increase the force of the traction to greater than body weight.
D. Place the patient in prone position with a pillow under the pelvis.

ANS: A

6. The most commonly used parameters for cervical traction are which of the following?
A. Neutral cervical spine, intermittent, up to 50 pounds
B. Cervical flexion of 15 to 35 degrees, constant, no more than weight of the head (about 10 to
15 pounds)
C. Extension of the upper cervical spine, intermittent, 15 to 30 pounds
D. Cervical flexion, intermittent, 10 to 25 pounds

ANS: D

7. Which of the following is an indication for traction?

A. Distraction of facet joints to relieve pain from degenerative joint disease
B. Stretching of cervical spine ligaments to relieve pain from acute grade two ligament sprain
C. Increasing bone density of the cervical vertebral bodies for a patient with osteoporosis
D. Alleviation of bilateral upper extremity paresthesias secondary to cervical spinal cord
compression

ANS: A

8. Which of the following lists contains only contraindications or precautions for traction?
A. Spinal instability, uncontrolled hypertension, claustrophobia
B. Infection, osteoarthritis, hiatal hernia
C. Rheumatoid arthritis, facet joint capsulitis, upper extremity radiculopathy
D. Spine cancer, hiatal hernia, herniated nucleus pulposus

ANS: A
9. Which of the following is an appropriate guideline regarding the patient’s response to
traction?
A. Some discomfort is expected during traction and may temporarily increase afterward.
B. Traction should relieve pain in an extremity but may increase neck or back pain.
C. Pain increases during traction are common but should diminish afterward.
D. The patient should not have an increase in symptoms during or after traction.

ANS: D

10. Which of the following is the most important parameter to consider when the goal of traction
is separation of lumbar vertebral bodies?
A. Using heat before and during traction
B. Selecting an appropriate force
C. Using the supine position with the legs supported on a small stool
D. Using an intermittent setting

ANS: B

11. Which of the following is correct with regard to cervical traction?

A. Approximately 30 to 45 pounds of traction force is required to achieve vertebral separation in
the cervical spine.
B. Patients always have better outcomes when the traction force is as high as they can tolerate.
C. Cervical traction applied with the patient sitting requires more force to achieve the desired
effect than when applied with the patient supine.
D. A person with a history of temporomandibular joint problems should not have any form of
cervical traction.

ANS: C

12. Clinical effectiveness of traction appears to be best when performed

A. Alone, without other interventions
B. Combined with heat and massage
C. Combined with manual therapy and exercise
D. Combined with ultrasound and epidural injections

ANS: C

13. A recently published clinical prediction rule for cervical traction includes which of the
following?
A. Positive shoulder abduction test
B. Age of 50 years or younger
C. Negative upper limb tension test
D. Increased symptoms with manual distraction

ANS: A

14. Which of the following is true regarding lumbar spine decompression units?
A. Research has demonstrated that these units are more effective than standard traction tables.
B. There is lack of evidence in the literature to validate the effectiveness of these units.
C. These units are effective in relieving back pain but not radiculopathy.
D. Space-age technology is applied to reduce bulging and herniated discs effectively.

ANS: B

15. Your patient is considering purchasing an inversion device for her back pain. Which of the
following medical problems would preclude her use of this device?
A. Osteoarthritis of the spine
B. Temporomandibular joint dysfunction
C. Spinal stenosis
D. Hypertension

ANS: D